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411ECTRICAL PERMIT AP CATION <br /> '11P00/-%va , 1_ CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa_gov I www.everettwa.gov/permits <br /> Le -7 3 eta /l <br /> PROJECT1 � SITE'INFORMATII yON <br /> OVi <br /> PROJECT ADDRESS: 67 4-1'1 AveAVe, ) E P•e- ,44 B o 1 k& C , <br /> BUILDING AREA(if residential,new construction,remodel,or addition) a:2A 1,5"& SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: Ili-COMMERCIAL <br /> USE OF BUILDING: Upct.t'tklij;Y,ti` C'u Ft CA-- <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ ,2_,S.-1 U v U <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: .- r 00 A `�"',U l✓ P�I�. <br /> . e.(,5� i ` 1}-S%AV A "Tsw fae <br /> t(' <br /> 1- tap cgo'6 v i r,t•Li. ( ?G,u,C- 1, 13 G{In.A.-(Y •Fo c ‘e+,�t.k v c F I.c-z) <br /> CONTACT INFORMATION <br /> OWNER NAME: pc,, ,,,.N'k19t`, DeVe.LO(lt teM k((.-_ _TENANT NAME(If Commercial): ''(,C.I) (� <br /> OWNER MAILING ADDRESS: STREET V O +(3 )o t4 ^�4- tA...CL1 C 61-- cc' L%Q p �r <br /> CITY .ems Q_. STATE (AJ k ZIP GV i <br /> OWNER PHONE: ooc -.0>5 -3e 1 (OWNER EMAIL: <br /> CONTRACTOR NAME: OV6-er1 \--2... lC <br /> CONTRACTOR ADDRESS: STREET Za.s' JC k kn �V 5 -11 <br /> CITY !' <br /> 'tfC/l-,I, I STATE 1/U/4ZIP <br /> CONV,,Ii vly ofyytY - �d t• t'LC- '` <br /> CONTRACTOR PHONE:�,S3 -`�i�Zd2-L�US� 'CONTRACTOR EMAIL:J / <br /> CONTRACTOR LIC.#(REQUIRED):0 L-S IS/L)Et t31.P F---- ICITY OF EVERETT BUSINESS LIC.#(REQUIRED):Q'4 LOc^L <br /> PRIMARY CONTACT: 0 OWNER E CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 02,5-g ,g,----4,2„- L °lv c. <br /> 7\ - A (strce*K i CONTACT EMAIL:3 0 S4_," ✓ CSL SC„/'1 etc...64 4l2 t <br /> AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and ect. All provisions of laws and ordinances governing this <br /> type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or <br /> local law regulating construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only <br /> FEE <br /> Lt--I -00 I , <br /> PERMIT# <br /> 1/4//_ E ((�L'�" ��Z <br /> %�'°� � (Revised 10/12/2015) <br /> nerlAut ••rized Agent Signature Date <br />